Non-01 cholera vibrio enteritis

　　What are the causes of the onset of non-01 cholera vibrio enteritis

　　Non-01 cholera vibrio enteritis often complicates acute pulmonary edema, renal failure, and hypokalemia syndrome, etc., as follows.

　　1. Acute pulmonary edema:The main clinical manifestations are sudden onset of severe dyspnea, sitting breathing, accompanied by cough, often coughing up pink frothy sputum; the patient is restless, the lips are cyanotic, sweating profusely, the heart rate increases, the lungs are filled with moist rales and wheezing sounds, and severe cases can cause syncope and sudden cardiac arrest; metabolic acidosis can lead to pulmonary hypertension, which is further exacerbated by the administration of large amounts of saline without alkali.

　　2. Renal failure:It is divided into acute and chronic according to the urgency of onset, and acute renal failure is the loss of excretion function of both kidneys in a short period of time. Due to the failure to correct shock in time and hypokalemia, it is manifested by decreased urine output and azotemia, and severe cases may develop anuria, which can lead to death due to uremia.

　　3. Others:Hypokalemia syndrome, arrhythmia, and abortion, etc.

　　Most patients have an acute onset, a few cases 1-2 days before the disease; with symptoms such as dizziness, fatigue, abdominal distension, and mild diarrhea.

　　First, vomiting and diarrhea period

　　1. Diarrhea: No urgent defecation, usually not accompanied by abdominal pain, several times or dozens of times, fecal incontinence; yellow watery stool, rice water-like stool, wash meat-like stool.

　　2. Vomiting: Diarrhea followed by vomiting, usually without nausea; vomiting contents are stomach contents, rice water-like substances; mild cases may not have vomiting.

　　Second, dehydration period

　　1. Circulatory collapse: Manifestations of water loss shock, restlessness or confusion, cold extremities, fine pulse, rapid drop in blood pressure, even unable to measure; shortness of breath, cyanosis of skin and mucous membranes; decreased urine output, increased blood urea nitrogen; moderate and severe dehydration.

　　2. Uremic acidosis: Kussmaul breathing (deep and large breathing).

　　3. Muscle cramps: Large loss of salt in the body, severe hyponatremia, causing painful muscle; cramps and muscle rigidity, with gastrocnemius and rectus abdominis muscles being most prominent.

　　4, Hypokalemia: muscle tone decreases, reflexes disappear, abdominal distension, tachycardia, weak heartbeat, irregular heart rate, and other symptoms, as well as prolongation of Q-T interval on electrocardiogram, appearance of U waves, flat or inverted T waves, etc.

　　Third, convalescent period

　　After the patient's diarrhea stops and dehydration is corrected, most symptoms disappear. In a few cases, endotoxins enter the blood, fever 38～39℃, lasting for 1～3 days.

　　To prevent non-01 cholera vibrio enteritis, it is necessary to control the source of infection, interrupt the transmission route, and enhance population immunity, as follows:

　　1, Control the source of infection

　　Find patients as soon as possible, strictly isolate and treat them, and strictly quarantine close contacts for 5 days, and give prophylactic medication.

　　2, Interrupt the transmission route

　　Improve the environmental hygiene, strengthen drinking water disinfection and food management. Strictly disinfect the patient's belongings and excreta. Kill flies and mosquitoes.

　　3, Enhance population immunity

　　Inoculate B subunit-whole cell vaccine, strictly isolate the patients, strictly inspect service industry personnel such as food and drink, and promptly detect and treat carriers. Prevent fecal contamination of water sources, and disinfect potentially contaminated drinking water. Seafood or food that may be contaminated must be thoroughly cooked. Strictly separate raw and cooked foods, and keep the 'disease enters through the mouth' under control.

　　Non-01 cholera vibrio enteritis should be examined for blood, urine, and serological tests, as follows:

　　1, Blood examination

　　Due to fluid loss and blood concentration, red blood cell hematocrit increases, hemoglobin increases, and white blood cells can reach 10×109 to 30×109/L. Neutrophils and macrophages increase. Serum potassium and sodium are generally within the normal range in the early stage of the disease, but they are generally reduced after fluid replacement, but chloride is generally higher than normal, urea nitrogen increases, and HCO3- decreases (

　　2, Urinalysis

　　Most patients have acidic urine, which may contain protein, red and white blood cells, and casts. Urine specific gravity is between 1.010 and 1.025.

　　3, Fecal examination

　　Microscopic examination shows that half of the cases have mucus in the feces, and only a few white blood cells are seen. Take the fecal specimen immediately for direct drop examination, which can find bacteria with strong motility and shuttle-shaped movement. Dark field examination can show characteristic meteor-like movement of bacteria. At the same time as the microscopic examination, the specimen is inoculated into alkaline (pH 8.4) peptone water for enrichment, and then separated culture is performed.

　　4, Serological examination

　　Common serum agglutination test and bactericidal test cannot generally be used as the basis for early and rapid diagnosis, and are commonly used for epidemiological investigation or retrospective diagnosis.

　　In addition to general treatment for non-01 cholera vibrio enteritis, dietary therapy can also be used to alleviate symptoms.

　　1, Egg flower syrup:40 grams of egg flower, double the amount for those who collect fresh ones. Decoct in clear water, add appropriate amount of white sugar for seasoning, discard the residue and drink the soup.

　　2, Horse-tail amaranth and mung bean syrup:Horse-tail amaranth 50 grams or 100 grams of fresh horse-tail amaranth collected by oneself, mung bean 50 grams, decocted in water, add appropriate amount of brown sugar for seasoning, take twice a day.

　　3. Fresh porophyllum mung bean soup:Fresh porophyllum 120g (30g for dried), mung bean 30-60g. Decoct and take it as a drink, once a day, for 3-4 times consecutively.

　　4. Huanglian crispy:Huanglian 250g, black sesame 10g, sugar 100g, appropriate amount of vegetable oil. Peel the huanglian and cut into diamond-shaped pieces. Toast the black sesame for later use. Heat the pot, add vegetable oil, and when the oil is six成热, add the huanglian pieces to the pot and fry until the outer skin of the huanglian pieces is hard and the flesh is soft, floating on the surface of the oil. Remove and pour sugar into the hot pot, add a little water, and cook until the sugar syrup turns milky yellow. When the sugar syrup can be picked up with a chopstick to form threads, add the huanglian pieces and stir constantly to coat the outer layer of the huanglian pieces with syrup. Then sprinkle the black sesame and it is ready.

　　5. Houttuynia porridge:Houttuynia 50g, glutinous rice 100g, a little salt. Clean the houttuynia, cut into granular shape. Rinse the glutinous rice clean. Put the glutinous rice and houttuynia in a pot, add appropriate salt and water, bring to a boil with strong fire, then turn to low fire to cook until the rice is soft and becomes porridge. Take two times a day.

　　The treatment principle for non-01 cholera vibrio enteritis is strict isolation, timely fluid replacement, supplemented with antibacterial and symptomatic treatment, as follows:

　　First, strict isolation

　　Isolation according to Class A infectious diseases, confirmed and suspected cases are isolated until 6 days after the disappearance of symptoms, and fecal culture is performed every other day. Those with two consecutive negative results can be released from isolation.

　　Second, timely fluid replacement

　　It should follow the principles of early, rapid, adequate, prioritize salt over sugar, prioritize rapid over slow, correct acidosis and supplement calcium, and supplement potassium when there is urine. The dosage and speed of infusion should be determined according to the severity of the condition, degree of dehydration, blood pressure, pulse, urine volume, and plasma specific gravity.

　　Third, antibacterial treatment

　　1. This is an auxiliary treatment for fluid replacement therapy.

　　2. Antibacterial drugs can reduce the amount of diarrhea and can shorten the period of diarrhea and vomiting as well as the period of excretion.

　　3. Often use ciprofloxacin 0.25-0.5g, twice a day, norfloxacin 200mg for adults, three times a day. One of them can be selected, generally 3-5 days for 1 course.

　　Fourth, symptomatic treatment

　　1. Correct acidosis.

　　2. Correct shock and heart failure: hormones and vasoactive drugs such as digoxin and furosemide.

　　3. Correct hypokalemia.

　　4. Antitoxin therapy: Chlorpromazine, coptis chinensis.